Organization
EASTSHORE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN PETER FUGAL MD (OWNER)
(203) 878-5941
Entity
Organization
Contact information
Practice address
1556 NEW HAVEN AVE, MILFORD, CT 06460-8220
(203) 878-5941
Mailing address
1556 NEW HAVEN AVE, MILFORD, CT 06460-8220
(203) 878-5941
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16917
CDS
CT
Enumeration date
08/08/2006
Last updated
09/11/2025
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